The Indian Journal of Nutrition and Dietetics

Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

Complementary Feeding Practices among Children (6-23 months) in Rural Lucknow, North India: A Cross-sectional Study


Affiliations
1 School of Sociology and Social Work, Shri Ram Swaroop Memorial University, Lucknow -225 003, India
2 Department of Pediatrics, King George’s Medical University, Lucknow - 226 003, India
     

   Subscribe/Renew Journal


Malnutrition is widely prevalent in India. Improper complementary feeding (CF) practices contribute to child malnutrition resulting in growth failure, high morbidity and mortality. Objective of the study was to assess CF practices and associated factors among children (6-23 months) in rural India. This cross-sectional study was conducted with mothers of eligible children. Mothers were identified using systematic random sampling and only those who consented to participate and were permanent residents were included. Children whose mother was unavailable were excluded. Data on socio-demographic, maternal characteristics and CF indicators was collected from June to October, 2017.Data was analyzed using SPSS. Mothers of mean age 24.98+3.91 years participated. 58.3% of mothers terminated breastfeeding before recommended duration. Of 85.3% children that received CF, 35.9%, 45.6% and 18.4% children had timely, early and delayed CF. Risk of untimely introduction of CF was higher among children of general category. Maternal education, religion, family type, child‘s gender, birth weight and birth order were not significantly associated with untimely CF practices. A large proportion of children did not consume sufficient diverse complementary foods to meet energy and micronutrient requirements. Study findings show that CF practices were suboptimal. Considerable gap existed between WHO recommendations and breastfeeding continuation, initiation of CF and meal frequency and quantity. Behavioral interventions involving mothers may improve CF practices and ensure better survival.


Keywords

Complementary feeding, malnutrition, children, micronutrient, breast feeding
User
Notifications

  • UN Inter-agency group for child mortality estimation (2011) Levels and trends in Child Mortality: Report 2011, New York: UNICEF.

  • Liu, L., Johnson, H.L., Cousens, S., Perin, J., Scott, S., Lawn, J.E., Rudan, I., Campbell, H., Cibulskis, R., Li, M. and Mathers, C. Global, regional, and national causes of child mortality: An updated systematic analysis for 2010 with time trends since 2000. The Lancet, 2012, 379, 2151-2161.

  • Black, R. Micronutrient Deficiency: An underlying cause of morbidity and mortality. 2003.

  • National family health survey, India. Mumbai: International Institute for Population Sciences (IIPS) and Macro International; 2015-16. Available from: http://www.rchiips.org/nfhs/. Accessed: 1 January 2018.

  • Rytter, M.J.H., Kolte, L., Briend, A., Friis, H. and Christensen, V.B. The immune system in children with malnutrition- A systematic review. PloS one, 2014, 9, 105-107.

  • Shekar, M., Heaver, R. and Lee, Y.K. Repositioning nutrition as central to development: A strategy for large scale action. World Bank Publications. 2006.

  • Das, J.K., Salam, R.A., Imdad, A. and Bhutta, Z.A. Infant and young child growth. Reproductive, Maternal, Newborn and Child Health, 2016, 225.

  • UNICEF. Division of Communication. Tracking progress on child and maternal nutrition: a survival and development priority. UNICHEF 2009.

  • World Health Organization. Complementary feeding: report of global consultation, Geneva, 10-13 December 2011: summary of guiding principles. Available at: http://www.who.int/ nutrition/publications/infantfeeding/924154614X/en/ (accessed 15 September 2016).

  • World Health Organization. Complementary feeding: report of global consultation, Geneva, 10-13 December 2011: summary of guiding principles. Available at: http://www.who.int/ nutrition/publications/infantfeeding/924154614X/en/ (accessed 15 September 2016).

  • WHO, UNICEF, USAID, FANTA, AED, UC DAVIS and IFPRI. Indicators for assessing infant and young child feeding practices part 2: measurement. Geneva: The World Health Organization; 2010

  • Sachdev, Y. and Dasgupta, J. Integrated child development services (ICDS) scheme. Med. J. Armed Forces India, 2001, 57, 139-143.

  • Morisky, D.E., Kar, S.B., Chaudhry, A.S., Chen, K.R., Shaheen, M. and Chickering, K. Breastfeeding practices in Pakistan. Pak. J. Nutr., 2002, 1, 137-142.

  • Hackman, N.M., Schaefer, E.W., Beiler, J.S., Rose, C.M. and Paul, I.M. Breastfeeding outcome comparison by parity. Breastfeeding Med., 2015, 10, 156-162.

  • Radwan, H. Patterns and determinants of breastfeeding and complementary feeding practices of Emirati Mothers in the United Arab Emirates. BMC public health, 2013, 13, 171.

  • Kang, N.M., Choi, Y.J., Hyun, T. and Lee, J.E. Associations of breastfeeding knowledge, attitude and interest with breastfeeding duration: A cross-sectional web-based study. J. Korean Academy. Nursing, 2015, 45, 449-458.

  • Gewa, C.A. and Chepkemboi, J. Maternal knowledge, outcome expectancies and normative beliefs as determinants of cessation of exclusive breastfeeding: A crosssectional study in rural Kenya. BMC public health, 2016, 16, 243.

  • Dunn, R.L., Kalich, K.A., Fedrizzi, R. and Phillips, S. Barriers and contributors to breastfeeding in WIC mothers: A social ecological perspective. Breastfeeding Med., 2015, 10, 493-501.

  • Meshram, I., Laxmaiah, A., Venkaiah, K. And Brahmam, G. Impact of feeding and breastfeeding practices on the nutritional. 2012.

  • Rao, S., Swathi, P.M., Unnikrishnan, B. and Hegde, A. Study of complementary feeding practices among mothers of children aged six months to two years- A study from coastal south India. The Aus. Med. J., 2011, 4, 252.

  • Sinhababu, A., Mukhopadhyay, D.K., Panja, T.K., Saren, A.B., Mandal, N.K. and Biswas, A.B. Infant and young child-feeding practices in Bankura district, West Bengal, India. J. Health, Population. Nutr., 2010, 28, 294.

  • Sisay, W., Edris, M. and Tariku, A. Determinants of timely initiation of complementary feeding among mothers with children aged 6–23 months in Lalibela District, Northeast Ethiopia, 2015. BMC Public Health, 2016, 16, 884.

  • Jamro, B., Junejo, A.A., Lal, S., Bouk, G.R. and Jamro, S. Risk factors for severe acute malnutrition in children under the age of five year in Sukkur. Pak. J. Med. Res., 2012, 51, 111.

  • Semahegn, A., Tesfaye, G. and Bogale, A. Complementary feeding practice of mothers and associated factors in Hiwot Fana Specialized Hospital, Eastern Ethiopia. The Pan Afr. Med. J., 2014, 18.

  • Schiess, S., Grote, V., Scaglioni, S., Luque, V., Martin, F., Stolarczyk, A., Vecchi, F. and Koletzko, B. Introduction of complementary feeding in 5 European countries. J. Pediet. Gastroenterol. Nutr., 2010, 50, 92-98.

  • Kimani-Murage, E.W., Kyobutungi, C., Ezeh, A.C., Wekesah, F., Wanjohi, M., Muriuki, P., Musoke, R.N., Norris, S.A., Griffiths, P. and Madise, N.J. Effectiveness of personalized, home-based nutritional counseling on infant feeding practices, morbidity and nutritional outcomes among infants in Nairobi slums: Study protocol for a cluster randomized controlled trial. Trials, 2013, 14, 445.

  • Holambe, V.M. and Thakur, N.A. Factors affecting late introduction of complementary food: a Kaplan Meier analysis. Nat. J. Comm. Med., 2014, 5, 140-143.

  • Senarath, U., Agho, K.E., Akram, D.E.S., Godakandage, S.S., Hazir, T., Jayawickrama, H., Joshi, N., Kabir, I., Khanam, M., Patel, A. and Pusdekar, Y. Comparisons of complementary feeding indicators and associated factors in children aged 6–23 months across five South Asian countries. Mat. Child Nutr., 2012, 8, 89-106.

  • Ogunlesi, T.A., Ayeni, V.A., Adekanmbi, A.F. and Fetuga, B.M. Determinants of timely initiation of complementary feeding among children aged 6 24 months in Sagamu, Nigeria. Nige. J. Clin. Prac., 2014, 17, 785-790.

  • Kabir, I., Khanam, M., Agho, K.E., Mihrshahi, S., Dibley, M.J. and Roy, S.K. Determinants of inappropriate complementary feeding practices in infant and young children in Bangladesh: secondary data analysis of Demographic Health Survey 2007. Mat. Child Nutr., 2012, 8, 11-27.

  • Joshi, N., Agho, K.E., Dibley, M.J., Senarath, U. and Tiwari, K. Determinants of inappropriate complementary feeding practices in young children in Nepal: secondary data analysis of Demographic and Health Survey 2006. Mat. Child Nutr., 2012, 8, 45-59.

  • Patel, A., Pusdekar, Y., Badhoniya, N., Borkar, J., Agho, K.E. and Dibley, M.J. Determinants of inappropriate complementary feeding practices in young children in India: secondary analysis of National Family Health Survey 2005–2006. Mat. Child Nutr., 2012, 8, 28-44.

  • Haile, D., Belachew, T., Berhanu, G., Setegn, T. and Biadgilign, S. Complementary feeding practices and associated factors among HIV positive mothers in Southern Ethiopia. J. Health, Popul. Nutr., 2015, 34, 5.

  • Shi, L. and Zhang, J. Recent evidence of the effectiveness of educational interventions for improving complementary feeding practices in developing countries. J. Tropi. Pediat., 2011, 57, 91-98.

  • Lassi, Z.S., Das, J.K., Zahid, G., Imdad, A. and Bhutta, Z.A. Impact of education and provision of complementary feeding on growth and morbidity in children less than 2 years of age in developing countries: A systematic review. BMC public health, 2013, 13, 13.

  • Bhutta, Z.A., Das, J.K., Rizvi, A., Gaffey, M.F., Walker, N., Horton, S., Webb, P., Lartey, A. and Black, R.E. Evidence-based interventions for improvement of maternal and child nutrition: What can be done and at what cost? The lancet, 2013, 382, 452-477.


Abstract Views: 463

PDF Views: 1




  • Complementary Feeding Practices among Children (6-23 months) in Rural Lucknow, North India: A Cross-sectional Study

Abstract Views: 463  |  PDF Views: 1

Authors

Tuhina Rastogi
School of Sociology and Social Work, Shri Ram Swaroop Memorial University, Lucknow -225 003, India
Geetanjali Srivastava
School of Sociology and Social Work, Shri Ram Swaroop Memorial University, Lucknow -225 003, India
Shally Awasthi
Department of Pediatrics, King George’s Medical University, Lucknow - 226 003, India

Abstract


Malnutrition is widely prevalent in India. Improper complementary feeding (CF) practices contribute to child malnutrition resulting in growth failure, high morbidity and mortality. Objective of the study was to assess CF practices and associated factors among children (6-23 months) in rural India. This cross-sectional study was conducted with mothers of eligible children. Mothers were identified using systematic random sampling and only those who consented to participate and were permanent residents were included. Children whose mother was unavailable were excluded. Data on socio-demographic, maternal characteristics and CF indicators was collected from June to October, 2017.Data was analyzed using SPSS. Mothers of mean age 24.98+3.91 years participated. 58.3% of mothers terminated breastfeeding before recommended duration. Of 85.3% children that received CF, 35.9%, 45.6% and 18.4% children had timely, early and delayed CF. Risk of untimely introduction of CF was higher among children of general category. Maternal education, religion, family type, child‘s gender, birth weight and birth order were not significantly associated with untimely CF practices. A large proportion of children did not consume sufficient diverse complementary foods to meet energy and micronutrient requirements. Study findings show that CF practices were suboptimal. Considerable gap existed between WHO recommendations and breastfeeding continuation, initiation of CF and meal frequency and quantity. Behavioral interventions involving mothers may improve CF practices and ensure better survival.


Keywords


Complementary feeding, malnutrition, children, micronutrient, breast feeding

References





DOI: https://doi.org/10.21048/ijnd.2019.56.2.22893